DEPARTMENT OF CLINICAL PHARMACOLOGY, WROCLAW MEDICAL UNIVERSITY, WROCLAW, POLAND.
Wiad Lek. 2021;74(7):1728-1736.
Bacterial urinary tract infection (UTI) is the most common infection, both in outpatient treatment and in hospital settings. Clinically, UTIs are classified into lower or upper urinary tract infections and can be either episodic or recurrent, and either uncomplicated or complicated. A severe UTI can lead to urosepsis and septic shock, while recurrent episodes of uncomplicated UTIs are considered to be an important etiological factor for the development of chronic kidney disease. The aim of this paper was to briefly discuss the classification, symptomatology and pathophysiology of a UTI and describe the rationale for the development of some drug-related urinary tract infections. The pathophysiology of a UTI is associated with multiple, anatomical and physiological dysfunctions that predispose infection, but there are also some iatrogenic factors, including the use of certain medications, that contribute to UTI development. Among drugs associated with an increased risk of UTI development one should mention immunosuppressants, agents affecting normal voiding processes and increasing the intravesical volume of residual urine, drugs promoting lithogenesis in the urinary tract with the subsequent favouring of urinary stone formation or drugs that reduce glucose reabsorption in the kidneys, causing glycosuria ("gliflozins").
Conclusions: Therefore, a UTI may also be a specific manifestation of adverse drug reactions and it should be taken into account in the monitoring and diagnosing of druginduced disorders.
细菌性尿路感染（UTI）是最常见的感染，无论是在门诊治疗还是在医院环境中。临床上，UTI 分为下尿路感染和上尿路感染，可分为偶发性或复发性，也可分为单纯性或复杂性。严重的 UTI 可导致尿脓毒症和感染性休克，而反复发作的单纯性 UTI 被认为是慢性肾脏病发展的一个重要病因。本文旨在简要讨论 UTI 的分类、症状和病理生理学，并描述一些与药物相关的 UTI 发展的原理。UTI 的病理生理学与多种解剖和生理功能障碍有关，这些功能障碍易导致感染，但也存在一些医源性因素，包括使用某些药物，这些因素也会导致 UTI 的发展。在与 UTI 发展风险增加相关的药物中，应提到免疫抑制剂、影响正常排尿过程并增加膀胱内残余尿液量的药物、促进尿路结石形成的药物或降低肾脏葡萄糖重吸收导致糖尿（“格列净”）的药物。
因此，UTI 也可能是药物不良反应的一种特殊表现，在监测和诊断药物引起的疾病时应予以考虑。
